Albumin-Indocyanine Green Evaluation Grading System Predicts Post-Hepatectomy Liver Failure for Biliary Tract Cancer

Albumin-Indocyanine Green Evaluation Grading System Predicts Post-Hepatectomy Liver Failure for Biliary Tract Cancer
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白蛋白-吲哚菁绿评估分级系统可预测胆道癌肝切除术后肝功能衰竭

DOI:
10.1159/000486142
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发表时间:
2018
期刊:
影响因子:
2.7
通讯作者:
Sakamoto Hirohiko
Sakamoto Hirohiko
中科院分区:
医学3区
文献类型:
--
作者:
Miyazaki Yoshihiro;Kokudo Takashi;Amikura Katsumi;Takahashi Amane;Ohkohchi Nobuhiro;Sakamoto Hirohiko

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背景在胆道癌治疗中,术前精确评估患者的肝功能对于避免肝切除术后肝衰竭(PHLF)和死亡至关重要。本研究旨在评估白蛋白-吲哚菁绿评估(ALICE)分级系统在预测胆道癌患者PHLF中的作用。方法对2000年至2016年因胆道癌接受肝切除术的166例患者的数据进行回顾性分析。通过单变量和多变量分析来确定 PHLF 的危险因素。结果 在 166 例患者中,101 例(61%)患者进行了主要肝切除术,99 例(60%)患者进行了胆管切除术。十三名 (8%) 患者出现 PHLF。此外,高 ALICE 等级 (≥ 2b) 患者的 PHLF、主要并发症和死亡率显着高于低 ALICE 等级 (< 2b) 患者(PHLF,42 vs. 18%,p= 0.002;主要并发症,35 vs. 19%,p= 0.036;死亡率,9.3 vs. 0%,p= 0.001)。在多变量分析中,高 ALICE 等级 (p= 0.016) 和失血量≥ 1,500 mL (p= 0.009) 被确定为 PHLF 的独立危险因素。结论 ALICE 分级系统有效地对胆道癌 PHLF 的风险进行了分层。
BackgroundIn biliary tract cancer treatment, a precise preoperative evaluation of the patient’s liver function is essential to avoid post-hepatectomy liver failure (PHLF) and mortality. The present study aimed to evaluate the role of the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting PHLF in biliary tract cancer patients.MethodsData from 166 patients who underwent hepatectomy for biliary tract cancer between 2000 and 2016 were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors for PHLF.ResultsAmong the 166 patients, major hepatectomy was performed in 101 (61%) and bile duct resection was performed in 99 (60%) patients. Thirteen (8%) patients developed PHLF. Furthermore, PHLF, major complications, and mortality were significantly higher in patients with high ALICE grades (≥ 2b) than in those with low ALICE grades (< 2b)(PHLF, 42 vs. 18%, p= 0.002; major complications, 35 vs. 19%, p= 0.036; mortality, 9.3 vs. 0%, p= 0.001). In multivariate analysis, high ALICE grade (p= 0.016) and blood loss≥ 1,500 mL (p= 0.009) were identified as independent risk factors for PHLF.ConclusionsThe ALICE grading system effectively stratified the risks for PHLF for biliary tract cancer.
藤田健二的写生本(第二版)
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DOI: 10.1016/j.cgh.2009.05.033
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